Director, Actuarial Services

  • 35939
  • Health - Actuarial
  • |
  • Missouri, United States
  • |
  • Sep 30, 2019
  • Develop the organization's premium rate structure through the forecasting of financial/ statistical data in a manner which is actuarially sound and competitive in the marketplace including cash flow analysis and financial projections.
  • Lead actuarial analysis and services in support of medical analysis, trend projections, and rate negotiations.
  • Oversee and analyze financial and claims data to evaluate utilization and unit price trends.
  • Assist with and participating in negotiations and presentations where appropriate.
  • Lead multiple projects involving development of Medicare Advantage and multiple Part D bids.
  • Assist in annual reserve calculations and financial statement filings, able to explain to clients.
  • Assist in monthly calculation of reserves and financial reporting.
  • Develop pricing consistent w/ financial and business objectives.
  • Develop and apply actuarial models to diverse client situations.
  • Balance growth and profitability goals to maximum results.
  • Design and oversee ad hoc health cost analyses.
  • Lead training and management of staff.
  • Manage client projects.
  • ASA or FSA.
  • Minimum 5 years of healthcare experience.
  • Experience with Medicare Advantage bid preparations/desk review required.
  • Client facing experience required; preferably external clients.
  • Experience handling multiple projects and bids required.
  • Strong communication skills including oral presentations and written reports.
  • Experience with complex actuarial projects that have a large financial and risk impact.
  • Technical proficiency in all aspects of health care actuarial practice including pricing, reserving, and data reporting.
  • High degree of self-motivation.